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The background art you see is part of a stained glass depiction by Marc Chagall of The Creation. An unknowable reality (Reality 1) was filtered through the beliefs and sensibilities of Chagall (Reality 2) to become the art we appropriate into our own life(third hand reality). A subtext of this blog (one of several) will be that we each make our own reality by how we appropriate and use the opinions, "fact" and influences of others in our own lives. Here we can claim only our truths, not anyone else's. Otherwise, enjoy, be civil and be opinionated! You can comment by clicking on the blue "comments" button that follows the post, or recommend the blog by clicking the +1 button.

Saturday, September 15, 2012

Crowded Theatres

During the Baltimore riots in 1968 following the assassination of Martin Luther King, Jr., destruction and looting were rampant throughout the downtown areas, police cordons were everywhere, and the scene generally was chaos. Throughout the riots, reporting in the newspapers and on radio and TV was strangely muted.  Afterwards, I asked an acquaintance who was a radio news reporter what had been going on; he told me that the media had voluntarily self-censored its reporting of the worst incidents to avoid making a bad scene worse.  So, to this day, some of the worst incidents go undocumented and unknown to the general public.  He could have claimed, as some media free-speech advocates do today in regard to the release of the blatantly anti-Muslim movie which set off the middle-eastern rioting, that freedom of expression required reporting everything.  But back then, even the New York Times reported only “all the news that’s fit to print.”
Most of the stridently (a pejorative, but it fits) free-speech advocates are in support of having no restrictions at all on the internet.  While there is some merit to their cause, there also is some excess.  They, mostly from the U.S., think like the teenager in terms of unrestricted freedom rather than responsible liberty.  They perhaps grossly understate the importance and the role of the internet in our current society.  Being from the U.S., they should know that one person’s freedom ends at the end of the other peoples’ nose, and that freedom of expression “does not include the right to shout ‘fire’ in the middle of a crowded theatre.”  Those are understandings of the responsibilities of liberty, not irresponsible freedom, established long ago by the U.S. Supreme Court. Freedom of expression does not include incitement to riot.  And evidence of damage to the other person’s nose includes, in the case of the anti-Islamic movie, dead bodies and burning buildings.  More recently, the Supreme Court ruled that you can not be required to serve as the conduit of another's expression.  In other words, freedom of expression includes the right not to express the views of another.
Nowadays, the internet is a crowded theatre for the whole world.  The days are past when the web was the private playhouse of the cognoscenti, and saying anything, no matter how outrageous, was speaking to a highly tolerant private audience.  Wildly variant values, deep misunderstandings, and restless mobs roam the aisles.  We are far yet from generally acceptable norms of “community” behavior in the internet theatre that would legitimate governmental censorship, but far enough along to know that responsibility for consequences goes with expression.  The right not to express becomes even more important.  That is why the self-censorship of Google in restricting access to the movie from parts of the Middle East was appropriate, and might have not gone far enough.  The internet has grown up.  It’s time for some of its sponsors to do so as well.

Wednesday, September 12, 2012

Cheese Cake Medicine

You don’t expect to find a cure for soaring medical costs in a mass-market restaurant chain.  Yet that is where Atul Gawande, an American physician known for his expertise in reducing error and improving efficiency in surgery, went searching.  His quest, reported in the August 13 New Yorker magazine, demonstrates lateral thinking that is just the kind we need much more of these days. It also reveals a fundamental flaw in the standard medical practice model that needs correcting to keep good health within the reach of the average person.
Gawande’s search took him to the Cheese Cake Factory, a leader in the “casual dining” business through its use of automation and carefully engineered kitchen work processes in all of its  restaurants.  Each kitchen is precisely laid out to the same floor plan, chefs cook each dish to exacting specifications that are the same everywhere and time and motion management are ruling principles.  But the key is the kitchen manager, who inspects each dish before it goes to the customer, rates it, and ensures any flaws are corrected.  This is a “best practices” model that does not permit variations according to the idiosyncrasies of a chef – it may not reach the sublime heights of an Emeril Lagasse, but it ensures against burnt toast or overdone steak.   And it provides good, $15 entrees.
Gawande then examined emerging medical practices at places like Brigham and Women’s Hospital (BWH) in Boston.  At many large and busy hospitals, you may encounter a half-dozen different physicians giving conflicting diagnoses and instructions, tests may be unreported or ignored, quality of care by the staff irregular, etc., etc.  Gawande counted 63 different personnel involved in his mother’s care during a recent knee procedure.  The medical profession is following what is known as a traditional “craft” model.  Doctors are self-employed and view themselves as providing a unique product using techniques, methods and materials unique to them. Major improvements in treatment in the medical profession take, on average, more than 15 years to become wide spread.  The results of this system can be lovely, but they are error prone and expensive.  At BWH, in the orthopedic surgery department, they have begun using instead a “best practices” model for knee surgery.  Specified common steps are required for all anesthesias and post-operative regimens, acceptable surgical practices are spelled out, and medical devices must be from a list of the ten least expensive devices (studies have shown no real differences in effectiveness between knee devices varying widely in cost, but each doctor, until now, had their own “pet” device).  When doctors informed their suppliers of the “ten cheapest” requirement, the reductions in price were remarkable.
The results at BMH were revealing:  length of stay was reduced by a day, patients’ pain levels cut almost in half, and measures such as distance walked, stair-climbing ability, standing ability, etc., improved about 50 percent.   And just the reduced stay by itself saves an average of $2000 per patient.  The “best practices” approach is being tried in different specialty areas at hospitals across the country, and there, too, results can be startling.  At the University of Michigan Hospital, for example, standardized “best practices” in blood transfusion produced a reduction in need for transfusion of 31 percent and a reduction of costs of $200,000 per month.  “Mass-medicine” chains are beginning to emerge across the country.  But, as Gawande reports, the pace of change in medicine can be glacial.
Resistance to change stems in large part from the traditional “craft” view of the hospital as the physician’s “workshop”, where everything is done for the convenience of the physician, not the patient.  That can be seen daily at any hospital, where very ill patients are waked at 3am for tests, so that results may be ready for the physician when he arrives.  In the emerging model at its best, the hospital is viewed as “a temporary residence for frail and very ill people”, and all activity is oriented to providing for their best possible care.  We now are at a juncture in medicine somewhat like the emergence of factories replacing cottage industries during the Industrial Revolution.   Only 25 percent of physicians report themselves as self-employed anymore, and a growing number of hospital “chains” have their quality of performance monitored electronically at a distance.  Resentful employees sometimes are reluctant to accept standards they were never trained to honor.  At this stage, good things may be either gained or lost in the change process.  Better quality at lower cost is the goal.  But in the process, either patient care or health professional job satisfaction may be at risk, also.  One danger is that health entrepreneurs may turn lower costs into higher profit margins instead of gains for the patient.  In the early industrial revolution, fringe industrial zones where horrible work and living conditions prevailed were sometimes known as “hell’s kitchens.”  We can tolerate nothing like that for treatment of the ill.  Perhaps it is appropriate that ultramodern, well-managed kitchens producing fine products to exacting standards become our new model for medicine.

Friday, September 7, 2012

The Search for The Golden Middle Way

I have some favorite exotic words that I savor, lifted from other languages – words with magic in them, words that spark the imagination, words of charm and elegance, words of comfort and hope.  I, for example, like the French word “papillon”; it’s so much more charming than its English translation, “butterfly”, possibly because I don’t find it as common a term as a native French speaker might.  But my favorite word of all time would have to be “sophrosyne.”  It rolls off the tongue with such elegance, mingled with charm; but above all it contains such mysteries that understanding it is a life-long quest.  It is an old Greek word that is essentially untranslatable.  Or rather, its translation is a project that must be accomplished within each person, for it denotes not a thing, but an approach to living.  Plato describes it in his dialogue, Charmides.  It represents a healthy-minded way of life characterized by harmony, moderation and avoidance of unproductive extremes, and was perhaps the primary social goal of ancient Greece. It was first translated for me as “the golden middle way is best.”  The closest approach to a short translation might be to take the two phrases carved on the entrances of the temple of the Oracle of Delphi, “Know Thyself” and “Nothing to Excess”, and to stir them in your head until you get it right.  That’s been my goal all my adult life.
My yearning for sophrosyne was heartened recently by two reviews, one a really fine article on Sunday, September 2, by Stephen Pearlstein in the Washington Post, the other the final chapter in David Rothkopf’s book, Power, Inc.  That the paradigm shift in economics that I mutter about from time to time is well underway is evidenced by both.  They reveal through many sources a general perception by conservatives and liberals alike that American capitalism is severely ill, and requires substantial treatment for its restoration to health. They further reveal that the search is underway for some middle way to accomplish that.  The general recognition that other alternatives such as communism (itself an intellectual extreme of the 19th century), will not resolve the issues shows a healthy-minded regard for realities that has sometimes been lacking in the past.
Pearlstein, in his review, focuses on a variety of diagnoses of the illness favored by different experts from right and left.  All seem to agree, for starters, that, in Pearlstein’s words, “A pure market economy is an ideological fantasy; even the freest markets operate in a framework of laws, infrastructure, institutions and informal norms of behavior in which government is heavily implicated.” In other words, all sides are beginning to reject the intellectual excesses of pure free market theory. The most extreme conservative, Edward Conard, a funder of Mitt Romney, argues that the illness is insufficient income inequality, while, at the other end of the spectrum, Nobel Laureate Joseph Stiglitz argues that the problem is an inequality gone wild that has led to governance by plutocracy.  Rather like the blind men and the elephant, various experts argue that the problem is too much promotion of business rather than the market itself (Luigi Zingales), or reliance on the performance of financial expectations rather than the product market itself (Roger Martin), or lack of adequate regulatory infrastructure (Jeffrey Sachs.), or lack of accounting for what Stiglitz calls social capital, Zingales calls civic capital, and Martin calls the civil foundation.
Rothkopf focuses not on the diseases of capitalism but on real world variations of capitalism that are being tried in countries around the world.  He makes a persuasive argument that American laissez-faire capitalism, itself a fossil of the 19th century without the built-in  means to manage stateless supercitizens like multinational corporations, is unable as it stands to deal with the stresses of globalism, but that the real question is which form of capitalism can do better.  In addition to the American lightly regulated laissez-faire form, he posits four major competing models: Chinese state-managed capitalism, German and Scandinavian Eurocapitalism, Indian and Brazilian Democratic Development capitalism, and Singapore’s Entrepreneurial Small-market capitalism. Each country’s model has features tailored to its culture and stage of economic development; what they all have in common is a much larger role for government than that found in the U.S. 
Rothkopf’s vision is of a world in which government and business partner rather than compete.  Their missions can be to a large extent complementary, government to provide the “whole-person” needs of its citizenry, business to provide the goods and services sought by customers. Each has major goals and capacities the other simply cannot have. The 21st century task is to find a new proper balance, and that will require abandonment of the ideological excess of the past.  The golden middle way is best.

Thursday, August 30, 2012

Creative Altruism

For me, possibly the greatest moment in American history came when George Washington declined to serve a third term as President and retired to Mt. Vernon.  At that time, he was held in such reverence that many proclaimed he should be declared king for life.  With his altruistic refusal to let that happen, he established once and for all the democratic nature of the American republic, and ensured the legacy of peaceful transition of office needed for its continuance.   He was following the example of Cincinnatus, the Roman farmer general, who, after heroically defending Rome from invasion, refused further office and retired to his farm, guaranteeing the rule of civil over military government for his and future generations.  A Society of the Cincinnati, composed of descendants of Revolutionary War officers,  exists to this day in Washington, D.C. to further the ideals of both Washington and Cincinnatus.
And they, of course, were probably following the even more ancient example of Solon, the great Athenian statesman, who, when asked to write a Constitution for the new Athenian democratic city state, included as its final clause, that on its passage he, Solon, should be exiled for life from Athens.  He truly could be termed the father of democracy.  History has many such acts of creative and heroic altruism, evidence that altruism can, in fact, change the world for the better.   A few, like those I’ve mentioned, loom large and are remembered.  Most are smaller, often forgotten acts that creatively open doors to subsequent history without calling attention to the actors themselves. One of those forgotten moments may be occurring in southern Europe now.
In Spain and elsewhere, the Washington Post reports, the Euro crisis is being met with the emergence of alternative economies, in which “hours” are traded for purchase of goods and services by those who, in many cases, have no Euros for currency but plenty of time.  Banks have established accounts for what the Spanish call “turutas” and businesses are buying and selling them for their goods and services. In places like Barcelona, thousands use them, and they are emerging as an alternative currency. They represent the role of currency purely as a medium of exchange, and are imperfect at best as a store of value.  But they fill the enormous vacuum left by the financiers and corporations who have focused solely on money’s role as a store of value and ceased treating it as it was originally created to be, a non-cumbersome medium of exchange for goods and services.  They buffer ordinary people from the worst ravages of the crisis.  They represent a statement by the Occupy and other related movements that alternatives exist to an oppressive economy dominated by financial interests alone, and may be a harbinger of steps to come in the economic paradigm shift.  And they may even call financiers’ attention to their own derelictions.
It takes altruism for a business person to purchase goods with Euros and sell them for turutas.  It takes altruism for a bank to set up accounts for deposit of Turutas and not Euros.  Not the kind of grand altruism of a Washington or Cincinnatus, but possibly historic nonetheless.  Perhaps this moment will pass, leaving only a quickly forgotten ripple.  But we may be witnesses to a moment when “business as usual” steps aside for the entrance of a new way.

Saturday, August 25, 2012

Curing the Cost of Health Care

Back in 2005, I had surgery for my arthritic back.  The surgeon was skillful, and the recovery, according to the doctor who lives next door, the smoothest he had ever witnessed.  In its execution, it was the kind of medical event in which American medicine can take justified pride.  Then I began getting copies of the bills sent for the surgery to Medicare and my insurance company.  While I had no out-of-pocket expense for the surgery, I was horrified.  The surgeon had sent a bill for $10,000, and was paid $2,000. Frankly, considering the skill he evidenced and the office overhead he supported, I thought the payment well justified and would have found a payment even of about $5,000 reasonable.  Then the hospital sent Medicare a bill for $25,000, of which all but a co-pay of $15 was paid by Medicare, with the private insurance picking up the $15.  Part of the bill was for legitimate hospital costs – operating room, room and board, nursing care, etc. – amounting to $9,000.  Though steep for two days of hospital care, I could pity the hospital a little and grudgingly swallow the costs.  But $16,000 of the cost was for a 2-inch titanium rod and two titanium screws inserted into my back.  I was appalled.  My son, an avid bicycler, commented that an entire titanium bike costs about $3,000. Excuses were made that custom tooling was expensive, health required exacting precision, etc., etc. They would have been valid even fifty years ago, but in an age of robotics and sub-atomic precision, they simply represented excuses for inefficiency. What had caused this charge, and what could be done about it?
The answers of course were greed and the legislated inability of Medicare to control charges by medical device makers.  While Medicare is allowed to squeeze excess out of doctors’ bills, often to the detriment of the patient, it is not allowed to regulate effectively either hospital charges or device manufacturers.  That in turn causes costs to be incurred somewhat akin to the $2,000 toilet seat charges the Pentagon faces from contractors.  The result is a tragedy for Medicare, which is blamed for costs it is not permitted to regulate. But the real tragedy is for American medicine and the American people.
In the Washington Post this morning, Matt Miller writes the first frank account of this issue I have seen.  Miller writes that we are debating Medicare in a bubble, “impervious to global benchmarks that suggest our efficiency ambitions are far too timid.”  We blame Medicare for escalating costs when the real villain is the entrenched inefficiency, and greed, of the private health care sector.  Other countries’ health systems deliver more effective health care than the U.S. at far lower per-capita costs.  The traditional excuse that our high health costs result from the superlative character of our health system just doesn’t fly. Internationally, we do not rank even in the top five of national systems for effectiveness, in terms of things like infant mortality, availability of coverage, etc.  Yet the most effective systems deliver health at a far lower percent of national GDP than ours does, with a more elaborate national administration, i.e., they are far more efficient despite having a higher governmental overhead. Our percent of GDP spent on health care is about 18, while OECD countries average 8 percent and Singapore, with similar effectiveness scores to ours, spends 4 percent.
 It turns out that the top national health systems in terms of effectiveness, none of which is the U.S., use a great variety of approaches, from all private providers as in Switzerland or Japan to all public single payer systems as in several European systems, but share one trait in common: all insist that no profit be made from the treatment of those who are ill.  Yet profiting from illness is at the heart (or lack thereof) of the American pharmaceutical and medical device manufacturing industries.  It turns out that the American insistence on private, unregulated costs of medical goods, pharmaceuticals and services is itself the illness we need to treat.  As Miller notes, we have given a license to inefficiency and excessive profits at the expense of the individual citizen.  A step toward a cure would be to provide for regulation of device and pharmaceutical costs by Medicare.
We celebrate the virtues of a free market, while forgetting that the market for esoteric goods and services to individuals who don’t understand them yet must have them cannot by definition be free.  Free markets imply perfect information and freedom of choice.  Our health services markets fail us constantly, with more neurosurgeons in Boston than in all England and whole rural counties without obstetricians, with 50 million uninsured, and with $16,000 2-inch rods about which the ultimate consumer has no choice.  Then we blame the messenger, Medicare, for exorbitant costs over which it has no control.  Health services are not luxury items like yachts, where we might sometimes pay willingly for old fashioned, handmade ornaments. Other countries have already shown us alternative ways to do things right.  It’s time we lifted our eyes beyond our ideology and looked to the future of effective and efficiently provided medicine.

Saturday, August 18, 2012

Common History

Back when Lyndon Johnson was first elected to the senate, his victory margin was, as I recall, about 87 highly mysterious votes that had turned up in a previously uncounted ballot box; he was quickly dubbed, and admiringly known, in Texas as Landslide Lyndon.  Folks up north thought of the event as the acme of crooked politics, and were suspicious of Johnson thereafter.  Texans knew better.  He had lost his previous run for the senate by around the same margin because of another mysterious ballot box turned up in a recount by cohorts of a West Texas political boss who was an arch rival of Johnson.  The feeling in Texas was that a turnabout was fair play.  What on the east coast was a violation of basic fair election rules was, in Texas, part of the ongoing election process.  I think of that sometimes when I’m following the European Debt crisis.
A friend of mine who often visits Germany, and has continuing conversations with friends there, tells me that his German friends see the continuing Euro mess as a straightforward matter, “There are rules, and you follow them.”  My southern European friends see things differently.  To them, Greece, and other southern European countries were systematically squeezed by northern European banks like Deutsche Bank, operating a lot like the U.S. banks that made no-questions-asked loans and then rapidly foreclosed in the run-up to the U.S. financial crisis.  Then Greece sought under the table assistance from Goldman Sachs (who better than they to know how to rig an intricate financial deal?) to stave off Deutsche Bank.  But Sachs had rigged the deal so that Greece suddenly found themselves several billion more in debt to Sachs than they had expected, more than their treasury could bear.  Greece had been caught in a pincer movement between two great white sharks.  So they adopted the classic southern “ok, now I can’t pay, what do you do?” approach, which set off the cascading events of the European debt crisis.  In other words, the crisis was set off by the loose financial practices of northern European banks, so why should southern Europe unilaterally suffer for it?
It’s now being generally recognized as a culture clash between northern and southern European values, but of course, other layers of the problem make it even more complex.  There’s also the growing suspicion on the part of southern Europeans that Germany’s long-term goal is to obtain a political hegemony over all Europe by financial extortion based on the strength of the German economy, a sort of economic Fourth Reich.  That makes countries like France or Britain less than eager to support Germany’s proposals.  All Europe is sliding into recession because southern Europe’s economies are being leached away by excessive debt loads, while German manufacturers face loss of customers for their markets by the very austerity German financiers seek to impose.  Germany itself begins to show internal policy conflicts.  German policy makers show increasing signs of wanting to help other European countries in need, but continuing reluctance to honor such divergent values.  It becomes increasingly obvious that economics alone has no solution for problems originally described in purely economic terms.
While many issues must be resolved to find solutions to Europe’s problems, one of the most interesting ones is never mentioned.  Solving the crisis will involve some degree of unequal sacrifice.  A perception of such sacrifice with a willingness to proceed requires altruism, but in turn, such altruism involves a sense of group identity.  A big reason why differences in political values between Connecticut and Texas, as well as other large cultural differences, never come to a head is that both share highly mobile populations and a crowded common history.  Texans frequently live in New England and New Englanders in Texas.  They both know what it’s like to live in the other place.  Just as important, they share common heritages, from the War of 1812, celebrated this year in both places, through to rocket probes on Mars.  "We Americans" is a common phrase.  Differences loom far smaller than commonalities.
I have never heard the phrase "We Europeans" from the lips of a European.  In Europe, Germans remain intensely German, and Spaniards Spanish.  In Italy, Florentines remain suspicious of Neapolitans.  And I have never heard a European discuss the common history of, for instance, Germany and Spain.  Each place has an exciting and memorable history, but a European history is a compendium of the histories of European countries, not a history of all together.  One never gets a sense of shared hardships overcome, shared triumphs, shared places of pilgrimage.  A European history is needed that reminds people of their common heritages and values, not their differences.  It is there: the era of the Holy Roman Empire, for example, had a more cross-national nature than anything in Europe today.  Charles Martel at Tours and the Venetian Fleet at Lepanto won great battles on behalf of all Europe.  Common memories and common heroes should abound.  But instead, European countries today compete, often bitterly, between each other for the European championship in soccer and blame each other for their problems..  No such competition and no such bitterness occurs between states in the U.S.  Until they can recognize a unity that goes far beyond a common currency, Europeans will never succeed in sharing a healthy common economy.

Monday, August 13, 2012

The Human Interest

Years ago, in a commencement address at American University, President John F. Kennedy stated, “While we proceed to safeguard our national interests, let us also safeguard human interests.”  A noble sentiment indeed, but one that seems forgotten in this 21st century fashion of unenlightened self interest.  It deserves notice that JFK did not raise the interests of humanity while ignoring national interest, but assumed instead that they can share common values and goals.  We especially seem to have forgotten that.  Time after time, we discount human goals and values obvious to the rest of the world as,”not in the national interest.”  There is a new principle of international law, embedded in the Law of the Sea Treaty (which of course the U.S. has as yet refused to accept) called "the common heritage of mankind" principle, which holds that all nations are bound to honor and hold in trust for future generations places such as sea beds, great historical sites, etc., that are the common property of humanity.  It, too, is a noble sentiment, well worth honoring.  But it has become fashionable among some conservatives to discount any values “not invented here” as suspicious attempts to Europeanize America, as though only those values not found in other nations can be truly American.  As I walked through flower-filled public spaces in Canada this summer remembering the colorless and joyless public streets common in the U.S. (“flowers – what a waste of money!”), I thought what a tragedy for the human spirit that attitude can become.
It is an old problem, written large in this new age of mass slaughters, globalized finance, an international struggle against terrorism and planetary climate change.  It’s said that we drive on the right side of the road and use the fork in the right hand in America because, following the Revolution, we didn’t want to be like the British.  De Tocqueville noted the problem in the 1840’s.  David McCullough, in The Greater Journey, an account of Americans in Paris in the 19th century, quotes a conversation between two Chicagoans at the Paris International Exposition of 1900 (site of the first presentation of the internal combustion engine, electric turbines, and now-priceless works of art, the fair was regarded by most as the grandest world fair ever held until that time):  First Chicagoan, “Well, it’s not as good as the Chicago Fair of 1876”; Second Chicagoan, “I knew that before I came.”  Some of us just haven’t changed.  But the world has.
Written large, the problem transforms from comedy into tragedy. My country’s skies are bluer than the oceans.  But other lands have skies as blue as mine.  So states one of the great hymns, based on the melody of Sibelius’s Finlandia.  We all share one planet, and a common humanity.  Yet we devote the equivalent of the entire corn crop of Iowa each year to corn syrup for soft drinks, while humanity around the world starves for lack of ability to pay the inflated food prices that result.  We cheerfully count arms sales to other countries that enable the mass slaughters as part of our world’s largest GNP.   We proclaim the world superiority of our educational and medical systems while we slide further and further down the international scales of effectiveness.  And in terms of climate change, we fiddle while the rest of the world (including us) burns.
Eugene Robinson, in the Washington Post, notes that the science of climate change is now confirmed to the point that previously skeptical scientists have reversed their positions, scientists previously cautious in describing the evidence are announcing that they had been significantly underestimating its effects, and a strong world consensus has emerged regarding the seriousness of the problem.  Other countries “get it.”  Yet in this country, Gallup polls show that public recognition of climate change and its consequences has actually declined, from 60 percent in 2007 down to 44 percent in 2011.  In the face of the hottest July in the hottest year on record, severe drought in Australia and emerging drought in our own Midwest, torrential rains in Russia, and floods covering one-third of Manila, many of us grit our teeth, square our jaws and hang on to full scale denial.  Robinson terms it the “You can’t pin it on our SUVs” view.
It’s time for the interests of humanity to come forward again as part of our legitimate public policy agenda.  Robinson suggests that global climate change should be part of the discussion in this current election, and I would agree with him.  I would also add subjects like the effect of our domestic policies on world poverty, and our national contribution to world violence.  We as a nation known for its impact on world affairs cannot disregard the effects of our actions on the common interests of all the world.  We cannot claim greatness without practicing it.

Thursday, August 9, 2012

The Price of Liberty

When I absolutely have to wear a tie at this time of year, which I’m glad is rarely, I like, if possible, to whip out an old Snoopy tie of mine.  Snoopy, you recall, is the beagle in the Peanuts comic strip who is truly the blithe spirit among a horde of often over-wrought kids (a little book, The Gospel According to Peanuts, provides a theological interpretation, which is my lame excuse for wearing the tie to church, that Snoopy represents the Holy Spirit trying to lighten up a bunch of overly striving Earnest Christians.) My Snoopy tie shows him in swimming trunks traipsing across the beach, whistling and wearing sun glasses; on the back of the tie it says, “My body may be at work but my mind is on vacation.” I’m just returned from an orgy of vacationing, including short trips to Canada and to Chautauqua, New York, sandwiched in between two separate weeks at the beach; my mind is still back there somewhere, whistling and hiding from me. Eventually, it’s bound to show up.
Meanwhile, I’ve been catching up on old opinion columns, and in the process found a few that as usual make a mishmash of the difference between Liberty and Freedom (one of the most common vices among all of us.)  One was in a column by Robert Samuelson, which reflected on the current crisis in capitalism in a serious way that deserves consideration. First, we all need to keep in mind that Freedom is the absence of all external constraints, while Liberty is the absence from the constraints of arbitrary or despotic government.  That difference is important.  Freedom is the fervent desire of every teenager; Liberty is the mature desire of adults to live together in an orderly society that recognizes and respects the needs of the individual while providing ground rules that enable all to live and work together peaceably and happily.  Freedom implies no obligations on anyone’s part; Liberty implies reasonable and non-arbitrary mutual obligations on the part of all of us.  Freedom implies the State of Nature in which we are all equally unconstrained and vulnerable; Liberty implies the Social Contract.
Samuelson writes in two different columns about democracy and about capitalism in a way that is subtly contradictory.  In one, about the bitter political strife in this election year, he writes that Americans are torn between their love of freedom and their love for equality to the point that it constitutes the great divide between conservative and liberal thought.  He cites de Tocqueville as a source of his belief that we seek equality because of our innate greed, and that egalitarianism will eventually win.  In the other, about the crisis of capitalism, he acknowledges that the implicit bargain that capitalism makes in exchange for the freedom of its profit making is that large returns on investments will be reinvested in ways of benefit to all, and that the bargain is being broken when companies just hang on to profits without reinvesting them productively.  He recognizes that lack of reinvestment is a big factor in the current recession, to the detriment of all.
Samuelson is right when he talks about our individual greed dragging us down, but wrong to forget that we are social animals, tied together by bonds of empathy and mutual accommodation.  Biology tells us that has been the key to our success as a species.  Even a small child knows instinctively what’s fair and what’s not.  Samuelson seems not to recognize that what he characterizes as greedy egalitarianism in us is that small child shouting, “That’s not fair!”  The violators in this case are the one-percenters and the corporations who are not doing their part in keeping our society going.  Paying taxes, reinvesting, refraining from price gouging, responsible treatment of employees, all are fundamental ethical practices required for a free society.  Miss Manners, in an article years ago in the American Scholar, commented that the enactment of a law represented the failure of an ethic.  Regulations are the consequence of unethical behaviors.  If businesses desire less regulation, then the key first step for them is to become models of ethical practice. The price of Liberty is not just eternal vigilance, it’s also responsible participation. 

Monday, July 30, 2012

Deconstructing Monsters

When I was growing up, I was taught that the common nickname for the devil, “Old Nick”, came from Niccolo Machiavelli, the author of The Prince.  I pictured him as red faced, with tiny hooves peeking out from beneath his robes.  After all, being called the devil is one thing; having the devil named for you something entirely beyond.  Then I came to read his works, and about him, and discovered he was actually an Italian patriot striving, vainly at that time, for the unification of Italy and independence from the domination of France.  And much of what he had to say made sense.
That sort of led me down the path of curiosity about other famous monsters – not in any way to excuse them, but to get a glimpse at what made them tick and created them in the first place.  For example, I discovered that Vlad Dracul the Impaler, aka Dracula, ruled amid constant threats of invasion from surrounding countries and chose to create his horrible reputation as a means of deterrence, and that Hitler blamed a Jewish surgeon for the death of his mother when he was an early teen, internalizing that as hatred for all Jews.  That in no way excuses Hitler, or Vlad, for their atrocities, but it does add dimension to the internal portraits of them that I carry about.
My wife and I just returned from a short visit with friends to Chautauqua, where the topic of the week was Pakistan, another monster we are busy creating these days.  Pakistan is the ally we love to hate.  We see Pakistan as just a little short of being itself a terrorist adversary, ruled by a fanatic military that shelters our enemies and threatens our military, while insisting we provide them with large foreign aid payments for their minimal and reluctant cooperation.  Little hooves beneath the robes are easy to imagine.  One of the fascinating things about Chautauqua though, is the speakers’ ability to provide insight by continually jumping beyond their topic.
Possibly the most interesting speaker that way was the last one, Karen Armstrong.  She is more known for her work on the interrelations of religion with culture than on things like foreign policy; in fact, she disclaimed any interest or expertise in the area, though she herself has visited Pakistan several times, serving at least as a sort of good will ambassador. She bounced her way through many topics, from the childhood of Buddha to the origins of modernity; on some I agreed with her and on others have my doubts.  Perhaps the strongest of her points was that we, as individuals and as nations, each have our unique history, not easily understood by others.  Pakistan, for example, was the home of Akbar the Great, roughly a contemporary with Elizabeth I of England; Akbar was the Mughal emperor who conquered most of northern and central India and ushered in a golden age.  He was famed for his tolerance, and though he himself was Muslim, his court advisors included Hindus and Jesuit representatives of the Pope.  Revered by Pakistanis as a founder of the nation, he himself struggled with pacifying Pashtu’s and with maintaining a delicate internal balance of power.  In other words, what we see as a contrary attitude on the part of Pakistan, they see as a way of life they have dealt with for centuries.  They have struggled with India through the ages. Though they have Islamic fanatics as they have had for centuries, they also have tolerant moderates, as they also have had for centuries.  Their internal priorities include maintaining a balance between them, which at times causes us to grit our teeth, and an uneasy peace with India.
The other key point Armstrong made was the importance, when thinking about the nation-state of Pakistan, of distinguishing between the nation and the state.  The nation is the repository of our national identity that stirs our patriotic passions; the state is the vehicle for the moderating rule of government that enables us to get along both with ourselves and with other nation-states without recourse to violence.  Our need in dealing with Pakistan is to strengthen the role of civilian government and to avoid creating vacuums that give chaotic outlet to national passions, in other words, to avoid abrupt departures or sudden changes in policy that destabilize their government; easier said than done.
A third point made by other Chautauqua speakers was that the real issue we are dealing with in Pakistan is our relations with China.  Any vacuum we create in the area of Pakistan and Afghanistan will be immediately filled by China, which is already seeking dominance of the area.  How content we are with that is the real determinant of our policy there.
So, we are uneasily tied to a monster.  But on closer inspection, it is a people with their own history and needs that we can partially understand and work with. There are even parts of their identity that we can appreciate and recognize as akin to our own.  That’s a starting point. 

Saturday, July 21, 2012

Guns and the Constitution

It used to be said in the early days in this country that the only books you really had to have were the Bible and Shakespeare.  Tucked in there, too, must have been some ancient history, for growing up in East Texas, I was surrounded by town names like Athens and Carthage and Palestine, and the Sabine River ran not far away.  Rural and small town people were knowledgeable both about ancient times and what was going on elsewhere in the world right then, for after all, the rest of the world was not all that different, and the technology for transmitting news, a rider on horseback, was equally available to all.  The big places, like Washington and Boston, were towns of about 25,000, the best size for a place according to Aristotle, and the lowest limit for calling the place a city according to the Census.  The Bible is still standard issue, but somewhere along the way the Shakespeare and the history and the urge to stay current seem to have gotten misplaced.  For in parts of this country, rural and small town culture is a static thing, deliberately and desperately clinging to the past.
In his fascinating mini-series on public television, about the Prohibition Era, Ken Burns brought that to the fore as an underlying force that generated the prohibition movement.  In the early 20th century, cities were becoming large and filled with new immigrants from strange places like Poland and Lithuania (there is no Krakow, Texas), who drank a lot.  Prohibition, in addition to all its other dimensions, represented the first major battlefield in what has become a more than 100 years war in this country between urban and small town culture.  The repeal of prohibition was a major victory for urban living and a grudgingly conceded defeat for the countryside.  Where I grew up, the joke was that Tyler would stay dry as long as the Baptists and the bootleggers could stagger to the polls.
A sadder victory for rural culture has been the long-term fierce allegiance to guns.  For guns, highly useful when protecting against rabid raccoons and snakes in the country, though useless as a modern missile defense, have no rightful place in a crowded urban movie house.  Yet the right to keep and bear arms, on the farm or in the movie house, continues to be a standard tenet of and a major victory for a small town culture that reveres all things from long ago.  The tragic consequences of this week’s shooting in Colorado will most likely again be ignored as “just the act of a madman”, when the real question is why the weapons were available in the first place.
From studying the Constitution and the Federalist Papers, I know full well that the language of the second amendment supports the right to bear arms, though it was intended, according to the Federalist Papers, to support their regulation for efficiency of militia operations.  That was in a time when opposing armies bore muskets, and bears and Indians were a real threat.  There were no crowded cities where a single person bearing a musket could pose a significant threat. The countryside’s fierce allegiance to a right that is no longer viable in urban culture is both misplaced and terrible in its consequence.  I am in general reluctant to consider changes in the Constitution; it is one of the great monuments to human progress and continues to serve us well.  But it is time to change or repeal the second amendment.  It is the relic of a violent past, and a promoter of a violent present.